Journal of Health And Care
Volume 22, Issue 4 (WINTER 2021)
JHC 2021, 22(4): 327-338 |
Back to browse issues page
Ethics code: IR.TBZMED.REC.1399.470
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Zarneshan A, Safaee N, Esmealy L, Esmealy B. Effects of Combined Stretching and Breathing Exercise on Hemodynamic and Oxygenation Changes in Patients Undergoing CABG Surgery. JHC 2021; 22 (4) :327-338
URL: http://hcjournal.arums.ac.ir/article-1-1262-en.html
URL: http://hcjournal.arums.ac.ir/article-1-1262-en.html
. Department of Sport physiology, School of Educational Sciences and Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
Abstract: (1955 Views)
Background & aim: Adequate oxygenation and hemodynamic stability are important goals of nursing care after coronary artery bypass graft (CABG). This study aimed to evaluate the effects of stretching combined with breathing exercise on hemodynamic and oxygenation changes in CABG patients.
Methods: In this randomized clinical trial study performed in 2020, 48 patients (35 men and 13 women) undergoing non-emergency CABG surgery at Shahid Madani Hospital of Tabriz were randomly divided into experimental (n=24) and control (n=24) groups. Evaluations of heart rate, blood pressure, and arterial blood oxygenation were performed before, immediately, and five day after exercises. Combined Stretching-breathing exercises were performed in the experimental group for five days and two times a day (morning and evening). The patients in the control group received the usual hospital care. Data were analyzed using ANCOVA at a significant level of p<0.05.
Results: After five days of combined stretching-breathing exercise, the mean oxygen pressure (F=12.90, p=0.001) and oxygen saturation (F=16.38, p<0.001) of arterial blood increased significantly, while heart rate (F=21.01, p<0.001) and mean carbon dioxide pressure (F=11.95, p=0.001) decreased significantly in the experimental group compared to the control group. Immediately after the intervention, no significant difference was observed between two groups in the research variables.
Conclusions: Based on the research findings, combined stretching-breathing exercise had a beneficial effect on improving heart rate and arterial blood oxygenation in CABG patients and this can speed patient recovery as a rehabilitation program.
Methods: In this randomized clinical trial study performed in 2020, 48 patients (35 men and 13 women) undergoing non-emergency CABG surgery at Shahid Madani Hospital of Tabriz were randomly divided into experimental (n=24) and control (n=24) groups. Evaluations of heart rate, blood pressure, and arterial blood oxygenation were performed before, immediately, and five day after exercises. Combined Stretching-breathing exercises were performed in the experimental group for five days and two times a day (morning and evening). The patients in the control group received the usual hospital care. Data were analyzed using ANCOVA at a significant level of p<0.05.
Results: After five days of combined stretching-breathing exercise, the mean oxygen pressure (F=12.90, p=0.001) and oxygen saturation (F=16.38, p<0.001) of arterial blood increased significantly, while heart rate (F=21.01, p<0.001) and mean carbon dioxide pressure (F=11.95, p=0.001) decreased significantly in the experimental group compared to the control group. Immediately after the intervention, no significant difference was observed between two groups in the research variables.
Conclusions: Based on the research findings, combined stretching-breathing exercise had a beneficial effect on improving heart rate and arterial blood oxygenation in CABG patients and this can speed patient recovery as a rehabilitation program.
Keywords: : Breathing Exercises, Coronary Artery Bypass, Hemodynamics, Muscle Stretching, Oxygenation
Type of Study: randomized clinical trial |
Subject:
nursing
Received: 2020/12/11 | Accepted: 2021/03/18 | Published: 2021/03/19
Received: 2020/12/11 | Accepted: 2021/03/18 | Published: 2021/03/19
References
1. Maleki A, Ghanavati R, Montazeri M, Forughi S, Nabatchi B. Prevalence of coronary artery disease and the associated risk factors in the adult population of Borujerd city, Iran. Journal of Tehran University Heart Center. 2019;14(1):1-5. [DOI:10.18502/jthc.v14i1.648] [PMID]
2. Sadeghi M, Hashemi M, Sararoudi RB, Merasi MR, Molaeinezhad M, Shamsolketabi H. Demographic and psychological predictors of recovery from coronary artery bypass graft. Journal of Education and Health Promotion. 2017;6(1):92-105. [DOI:10.4103/jehp.jehp_154_16] [PMID] [PMCID]
3. Borzou SR, Amiri S, Salavati M, Soltanian AR, Safarpoor G. Effects of the first phase of cardiac rehabilitation training on self-efficacy among patients undergoing coronary artery bypass graft surgery. Journal of Tehran University Heart Center. 2018;13(3):126-31. [DOI:10.18502/jthc.v13i3.132] [PMID]
4. Alam M, Hussain S, Shehzad MI, Mushtaq A, Rauf A, Ishaq S. Comparing the effect of incentive spirometry with acapella on blood gases in physiotherapy after coronary artery bypass graft. Cureus Journal of Medical Science. 2020;12(2):e6851. [DOI:10.7759/cureus.6851]
5. Hamid M, Akhtar MI, Ahmed S. Immediate changes in hemodynamics and gas exchange after initiation of noninvasive ventilation in cardiac surgical patients. Annals of Cardiac Anaesthesia. 2020;23(1):59-64. [DOI:10.4103/aca.ACA_69_18] [PMID] [PMCID]
6. Martin CG, Turkelson SL. Nursing care of the patient undergoing coronary artery bypass grafting. Journal of Cardiovascular Nursing. 2006;21(2):109-17. [DOI:10.1097/00005082-200603000-00006] [PMID]
7. Ahmadi N, Reza Masouleh S, Shekani Z, KazemNezhad Leili E. Hemodynamic changes and related factors in patients undergoing coronary artery bypass grafting surgery. Journal of Holistic Nursing. 2012;22(2):1-10.
8. Derakhtanjani AS, Jaberi AA, Haydari S, Bonabi TN. Comparison the effect of active cyclic breathing technique and routine chest physiotherapy on pain and respiratory parameters after coronary artery graft surgery: a randomized clinical trial. Anesthesiology and Pain Medicine. 2019;9(5):e94654. [DOI:10.5812/aapm.94654] [PMID] [PMCID]
9. Feizi H, Mohammadi H, Yazdannik A, Mirmohammadsadegh M. Effect of incentive spirometry and deep breathing exercises on arterial blood gas parameters after coronary artery bypass graft surgery. Cardiovascular Nursing Journal. 2016;5(3):52-58.
10. Panchal B, Gutami S. To Study the response of treadmill walking and cycle ergometer on the hemodynamic changes of post CABG surgery patients during immediate post-operative days. International Journal of Science and Healthcare Research. 2019;4(4):125-30.
11. Zanini M, Nery RM, de Lima JB, Buhler RP, da Silveira AD, Stein R. Effects of different rehabilitation protocols in inpatient cardiac rehabilitation after coronary artery bypass graft surgery: a randomized clinical trial. Journal of Cardiopulmonary Rehabilitation and Prevention. 2019;39(6):E19-E25. [DOI:10.1097/HCR.0000000000000431] [PMID]
12. Akhtar S, Ahmed F, Grover S, Srivastava S. Effect of respiratory muscle stretch gymnastics on pain, chest expansion, pulmonary functions and functional capacity in phase 1 post-operative CABG patients. Journal of Cardiology & Current Research. 2015;2(6):1-5. [DOI:10.15406/jccr.2015.02.00084]
13. Moradian ST, Najafloo M, Mahmoudi H, Ghiasi MS. Early mobilization reduces the atelectasis and pleural effusion in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial. Journal of Vascular Nursing. 2017;35(3):141-45. [DOI:10.1016/j.jvn.2017.02.001] [PMID]
14. Chaudhary S, Chaudhary NI, Ghewade B, Mahajan G. The immediate effects of breathing exercises with acapella and incentive spirometer on preventing early pulmonary complications following cabg- a comparitive study. International Journal of Current Research and Review. 2020;12(17):51-58. [DOI:10.31782/IJCRR.2020.121710]
15. Limonta E, Cè E, Esposito F. Effects of acute passive stretching on ventilatory pattern during prolonged cycle exercise. Sport Sciences for Health. 2012;7(2-3):105-10. [DOI:10.1007/s11332-012-0122-9]
16. Page P. Current concepts in muscle stretching for exercise and rehabilitation. International Journal of Sports Physical Therapy. 2012;7(1):109-19.
17. Farinatti P, Brandão C, Soares PP, Duarte AF. Acute effects of stretching exercise on the heart rate variability in subjects with low flexibility levels. Journal of Strength Conditioning Research. 2011;25(6):1579-85. [DOI:10.1519/JSC.0b013e3181e06ce1] [PMID]
18. Farinatti PT. Cardiovascular responses to passive static flexibility exercises are influenced by the stretched muscle mass and the valsalva maneuver. Clinics Journal. 2011;66(3):459-64. [DOI:10.1590/S1807-59322011000300017] [PMID] [PMCID]
19. Ghashghaei FE, Sadeghi M, Marandi SM, Ghashghaei S. Exercise-based cardiac rehabilitation improves hemodynamic responses after coronary artery bypass graft surgery. ARYA Atherosclerosis. 2012;7(4):151-56.
20. Mohammadi BolbolanAbad H, YazdanNik AR, MirMohammad Sadeghi M, KhalifehZadeh A. The effect of deep breathing exercise on arterial blood gases after Coronary Artery Bypass Graftingg (CABG). Journal of Research Development in Nursing. 2013;10:99-104.
21. Whitley E, Ball J. Statistics review 4: sample size calculations. Critical Care. 2002;6(4):335-41. [DOI:10.1186/cc1521] [PMID] [PMCID]
22. Almeida FdJF, Gambassi BB, Sauaia BA, Almeida AEAF, Ribeiro DAF, de Sousa PR, et al. Acute effects of aerobic exercise on the blood pressure of patients after coronary artery bypass grafting. American Journal of Cardiovascular Disease. 2019;9(4):28-33.
23. de Macedo RM, Faria-Neto JR, Costantini CO, Casali D, Muller AP, Costantini CR, et al. Phase I of cardiac rehabilitation: a new challenge for evidence based physiotherapy. World Journal of Cardiology. 2011;3(7):248-55. [DOI:10.4330/wjc.v3.i7.248] [PMID] [PMCID]
24. Urell C, Emtner M, Hedenström H, Tenling A, Breidenskog M, Westerdahl E. Deep breathing exercises with positive expiratory pressure at a higher rate improve oxygenation in the early period after cardiac surgery-a randomised controlled trial. European Journal of Cardio-Thoracic Surgery. 2011;40(1):162-67. [DOI:10.1016/j.ejcts.2010.10.018] [PMID]
25. Westerdahl E, Lindmark B, Eriksson T, Hedenstierna G, Tenling AJC. Deep-breathing exercises reduce atelectasis and improve pulmonary function after coronary artery bypass surgery. Chest. 2005;128(5):3482-88. [DOI:10.1378/chest.128.5.3482] [PMID]
26. Brasher PA, McClelland KH, Denehy L, Story I. Does removal of deep breathing exercises from a physiotherapy program including pre-operative education and early mobilisation after cardiac surgery alter patient outcomes? Australian Journal of Physiotherapy. 2003;49(3):165-75. [DOI:10.1016/S0004-9514(14)60236-1]
27. Brown SP, Miller WC, Eason JM. Exercise physiology: basis of human movement in health and disease: Philadelphia: Lippincott Williams & Wilkins; 2006.
28. Burton DA, Stokes K, Hall GM. Physiological effects of exercise. Continuing Education in Anaesthesia Critical Care Pain. 2004;4(6):185-88. [DOI:10.1093/bjaceaccp/mkh050]
29. Saitoh H. Changes in blood flow, PO2 and pH of the muscle during contraction. Nihon Seikeigeka Gakkai Zasshi. 1982;56(6):487-99.
30. Sands WA, McNeal JR, Murray SR, Ramsey MW, Sato K, Mizuguchi S, et al. Stretching and its effects on recovery: a review. strength & Conditioning Journal. 2013;35(5):30-36. [DOI:10.1519/SSC.0000000000000004]
31. Costa AS, Costa PH, de Lima CE, Pádua LE, Campos LA, Baltatu OC. ICU blood pressure variability may predict nadir of respiratory depression after coronary artery bypass surgery. Frontiers in Neuroscience. 2016;9:506-12. [DOI:10.3389/fnins.2015.00506] [PMID] [PMCID]
32. Sanchez-Gonzalez M, Kalfon R, Alvarez-Alvarado S, Arturo Figueroa M. The effects of stretching training on cardiac autonomic function in obese postmenopausal women. Alternative Therapies in Health Medicine. 2017;23(2):20-26.
33. Hotta K, Kamiya K, Shimizu R, Yokoyama M, Nakamura-Ogura M, Tabata M, et al. Stretching exercises enhance vascular endothelial function and improve peripheral circulation in patients with acute myocardial infarction. International Heart Journal. 2013;54(2):59-63. [DOI:10.1536/ihj.54.59] [PMID]
34. Naik GS, Gaur G, Pal G. Effect of modified slow breathing exercise on perceived stress and basal cardiovascular parameters. International Journal of Yoga. 2018;11(1):53-58.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |